Theophylline in COPD

Should theophylline be abandoned in patients with chronic obstructive pulmonary disease (COPD)? Even a recent study with low-dose theophylline on top of inhaled corticosteroids/long-acting beta-agonists has not shown any positive effects.

Jadwiga Wedzicha: That is an interesting question. Many years ago I used high-dose theophylline and I think as a bronchodilator it produced some effects, but we now have newer longer-acting bronchodilators. LAMA is a long-acting muscarinic antagonist, LABA is a long-acting beta-agonist. I think we have better therapies that no longer really require theophylline treatment. There was a suggestion that low-dose theophylline could enhance inhaled corticosteroid treatment, though I do not think that has been shown in trials or in practice.

I think my response is yes, I would abandon theophylline, but I would also make sure that we use some of the newer therapies available for management of COPD patients.